Fig. 10. Patient 1—post-operative evaluation of placement accuracy of the implants in the mandible. Green is the planned position; blue is the actual position
Fig. 10. Patient 1—post-operative evaluation of placement accuracy of the implants in the mandible. Green is the planned position; blue is the actual position
Fig. 9. Patient 1—prosthodontic end result 5 months after implant placement
Fig. 9. Patient 1—prosthodontic end result 5 months after implant placement
Fig. 8. Patient 2—intra-oral situation during orthodontic treatment at the age of 14. A temporary crown with bracket is fixed on the dental implant. Eight months after start of orthodontic treatment, the 34 is already close to the planned end position
Fig. 8. Patient 2—intra-oral situation during orthodontic treatment at the age of 14. A temporary crown with bracket is fixed on the dental...
Fig. 7. Patient 2—post-operative orthopantomogram (OPT) at age of 13. Situation 10 months after implant placement. Three months after starting the orthodontic treatment, the 34 is already erected
Fig. 7. Patient 2—post-operative orthopantomogram (OPT) at age of 13. Situation 10 months after implant placement. Three months after starting the orthodontic treatment, the 34 is already erect...
Fig. 6. Patient 1—post-operative orthopantomogram (OPT) at age of 18
Fig. 6. Patient 1—post-operative orthopantomogram (OPT) at age of 18
Fig. 5. he maxilla (left) and mandible (right) with drilling template and metal drilling inserts (Nobel biocare). b Drilling template for the mandible of patient 1. c Implant placement of patient 1. Dental implant placement in the mandible using the virtual developed tooth-supported templates and metal drilling inserts
Fig. 5. a Drilling templates of patient 1. Printed model of the maxilla (l...
Fig. 4. t goal. b Patient 2—virtual set-up of the ultimate implant position. One short dental implant was planned in region 35, based on the location of the mandibular nerve (orange), the impacted 34 (pink) and the bone quality and volume. c Patient 2—virtual set-up of the ultimate prosthetic treatment goal
Fig. 4. a Patient 1—virtual set-up of the ultimate treatment goal. b Patient 2â€...
Fig. 3. e CBCT and intra-oral scan at age of 18. b Patient 2—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 12
Fig. 3. a Patient 1—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 18. b Patient 2—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 12
Fig. 2. uation before start of orthodontic and implant treatment. Eleven permanent teeth (including 2 third molars) were congenitally missing and the 34 is impacted. To erect the 34, orthodontic treatment was desired. Due to the lack of stable anchorages in the third quadrant, it was decided to place one implant at tooth region 35 for orthodontic anchorage and future prosthetics. Due to very lim...
Fig. 1. osed deciduous teeth 55, 54, 65, 74, 75, 84, and 85 and start of orthodontic treatment. Eleven permanent teeth (including 4 third molars) were congenitally missing. b Patient 1—post-orthodontic situation at age of 16. The top of the mandibular processus alveolaris is small (upper). The interdental space at location of the second premolars in the maxilla is 7 and 14 mm at location of t...
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Filius, M.A.P., Kraeima, J., Vissink, A. et al. Three-dimensional computer-guided implant placement in oligodontia.
Int J Implant Dent 3, 30 (2017). https://doi.org/10.1186/s40729-017-0090-6
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Received: 27 March 2017
Accepted: 22 June 2017
Published: 08 July 2017
DOI: https://doi.org/10.1186/s40729-017-0090-6
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
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Author Marieke Filius, Joep Kraeima, Arjan Vissink, Krista Janssen, Gerry Raghoebar and Anita Visser state that there are no conflicts of interest.
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Correspondence to
Anita Visser.
Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
Marieke A. P. Filius, Joep Kraeima, Arjan Vissink, Gerry M. Raghoebar & Anita Visser
Department of Orthodontics, University of Groningen and University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
K...
The authors like to sincerely thank all co-workers from the Department of Orthodontics, University Center Groningen, The Netherlands, for the potent collaboration during the treatment process.
We also kindly thank native English speaker Jadzia Siemienski for critically reading our manuscript and making suggestions to improve the English.
This research did not receive any specific grant from fund...
Schalk-van der Weide Y, Beemer FA, Faber JA, Bosman F. Symptomatology of patients with oligodontia. J Oral Rehabil. 1994;21:247–61.
Filius MA, Cune MS, Raghoebar GM, Vissink A, Visser A. Prosthetic treatment outcome in patients with severe hypodontia: a systematic review. J Oral Rehabil. 2016;43:373–87.
Shen P, Zhao J, Fan L, et al. Accuracy evaluation of computer-designed surgical guide tem...
(Cone beam) computer tomography
Two-dimensional
Three-dimensional
Euclidian distances
Orthopantomogram
This technical advanced article introduces a fully digitalized workflow for implant planning in complex oligodontia cases. The application of computer-designed surgical templates enables predictable implant placement in oligodontia, where bone quantity and limited interdental spaces can be challenging for implant placement. The stepwise approach described in this technical advanced article provide...
This technical advanced article illustrated the benefit of a full three-dimensional virtual workflow to guide implant placement in oligodontia cases as well as that implants can be reliably placed at the planned positions with the technique proposed.
The described full three-dimensional virtual workflow has several advantages. First, the surgeon is pre-operatively better informed about the requir...
The surgical guides fitted well and facilitated implant placement. All implants were placed in the native bone. No dehiscences of the implant surface occurred.
Post-operative orthopantomograms (OPT) of patients 1 and 2 are shown in Figs. 6 and 7. In patient 1, six implants were placed (NobelParallel Conical Connection implants, Nobel Biocare Holding AG, Zürich-Flughafen, Switzerland; Length 8.5...
After raising a mucoperiostal flap, the dental implants were placed using the virtual developed tooth-supported drilling templates using metal inserts (Fig. 5c). It was checked whether no dehiscences of the implant surface were present.
A CBCT (ICat, Image Sciences International, Hatfield, UK; 576 slices, voxel size 0.3 mm, FOV: 11 × 16 cm) was made of two oligodontia patients (for patient details, see Figs. 1 and 2) for implant planning. Detailed patient information was obtained with regard to the nerve position and bone quality and quantity. In addition, a digital intra-oral scan was made to get a detailed 3D image of t...
Oligodontia is the congenital absence of six or more permanent teeth, excluding third molars [1]. The need for oral rehabilitation in patients with oligodontia is high as they often suffer from functional and aesthetic problems due to a high number of missing teeth. Implant-based prosthodontics seem to be favourable to improve oral function and aesthetics in oligodontia [2].
Implant treatment in ...
The aim of computer-designed surgical templates is to attain higher precision and accuracy of implant placement, particularly for compromised cases.
The purpose of this study is to show the benefit of a full three-dimensional virtual workflow to guide implant placement in oligodontia cases where treatment is challenging due compromised bone quantity and limited interdental spaces.
A full, digita...
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Figure 10. Patient 1—post-operative evaluation of placement accuracy of the implants in the mandible. Green is the planned position; blue is the actual position
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Figure 9. Patient 1—prosthodontic end result 5 months after implant placement
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Figure 8. Patient 2—intra-oral situation during orthodontic treatment at the age of 14. A temporary crown with bracket is fixed on the dental implant. Eight months after start of orthodontic treatment, the 34 is already close to the planned end position
Â
Figure 7. Patient 2—post-operative orthopantomogram (OPT) at age of 13. Situation 10 months after implant placement. Three months after starting the orthodontic treatment, the 34 is already erected
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Figure 6. Patient 1—post-operative orthopantomogram (OPT) at age of 18
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Figure 5. a Drilling templates of patient 1. Printed model of the maxilla (left) and mandible (right) with drilling template and metal drilling inserts (Nobel biocare). b Drilling template for the mandible of patient 1. c Implant placement of patient 1. Dental implant placement in the mandible using the virtual developed tooth-supported templates and metal drilling inserts
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Figure 4. a Patient 1—virtual set-up of the ultimate treatment goal. b Patient 2—virtual set-up of the ultimate implant position. One short dental implant was planned in region 35, based on the location of the mandibular nerve (orange), the impacted 34 (pink) and the bone quality and volume. c Patient 2—virtual set-up of the ultimate prosthetic treatment goal
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Figure 3. a Patient 1—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 18. b Patient 2—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 12
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Figure 2 a Patient 2—pre-implant orthopantomogram (OPG) at the age of 12. Situation before start of orthodontic and implant treatment. Eleven permanent teeth (including 2 third molars) were congenitally missing and the 34 is impacted. To erect the 34, orthodontic treatment was desired. Due to the lack of stable anchorages in the third quadrant, it was decided to place one implant at tooth...
Â
Â
Figure 1. a Patient 1—orthopantomogram (OPT) at age of 13. Situation before extraction of the ankylosed deciduous teeth 55, 54, 65, 74, 75, 84, and 85 and start of orthodontic treatment. Eleven permanent teeth (including 4 third molars) were congenitally missing. b Patient 1—post-orthodontic situation at age of 16. The top of the mandibular processus alveolaris is small (upper). T...
Results
Clinical and radiographic assessments
The surgical guides fitted well and facilitated implant placement. All implants were placed in the native bone. No dehiscences of the implant surface occurred.
Post-operative orthopantomograms (OPT) of patients 1 and 2 are shown in Figs. 6 and 7. In patient 1, six implants were placed (NobelParallel Conical Connection implants, Nobel Biocare Ho...
Patient and methods
Implant planning and placement
Pre-implant procedure and 3D planning
A CBCT (ICat, Image Sciences International, Hatfield, UK; 576 slices, voxel size 0.3 mm, FOV: 11 × 16 cm) was made of two oligodontia patients (for patient details, see Figs. 1 and 2) for implant planning. Detailed patient information was obtained with regard to the nerve position and bone quality an...
Introduction
Oligodontia is the congenital absence of six or more permanent teeth, excluding third molars [1]. The need for oral rehabilitation in patients with oligodontia is high as they often suffer from functional and aesthetic problems due to a high number of missing teeth. Implant-based prosthodontics seem to be favourable to improve oral function and aesthetics in oligodontia [2].
Impla...
Three-dimensional computer-guided implant placement in oligodontia
Abstract
Background
The aim of computer-designed surgical templates is to attain higher precision and accuracy of implant placement, particularly for compromised cases.
Purpose
The purpose of this study is to show the benefit of a full three-dimensional virtual workflow to guide implant placement in oligodontia cases where t...
Â
author (y)
material used for fabrication of the template
radiographic marker used
imaging system used
conversion process
indication/ advantages
Engelman et al9
auto polymerizing acrylic resin
metal bearings
panoramic radiography
remove lingual surface, leaving only facial surface of the teeth in the proposed implant site
inexpensive, easy, improved visibility, external irr...
Conclusion
Although the completely limiting design is considered a far superior design concept, most clinicians still adopt the partially limiting design due to its cost-effectiveness and credibility in the field. In addition, it has been observed that most clinicians use surgical guide templates that are based on cross-sectional imaging to facilitate accurate planning and guidance during the sur...
CAD/CAM-based Surgical Guide
CAD/CAM technology uses data from computerized tomography scan (CT)33 to plan implant rehabilitation. The CT images are converted into data that are recognized by a CT imaging and planning software. This software then transfers this presurgical plan to the surgery site using stereolithographic drill guides.34Â CAD/CAM-based surgical guides offer many advantages. For e...
Completely Limiting Design
Completely limiting design restricts all of the instruments used for the osteotomy in a buccolingual and mesiodistal plane. Moreover, the addition of drill stops limits the depth of the preparation, and thus, the positioning of the prosthetic table of the implant. As the surgical guides become more restrictive, less of the decision-making and subsequent surgical executi...
In such designs, the first drill used for the osteotomy is directed using the surgical guide, and the remainder of the osteotomy and implant placement is then finished freehand by the surgeon.6Â Techniques based on this design concept involve fabrication of a radiographic template, which is then converted into a surgical guide template following radiographic evaluation. Various authors have propos...
Nonlimiting Design
Nonlimiting designs only provide an indication to the surgeon as to where the proposed prosthesis is in relation to the selected implant site.6Â This design indicates the ideal location of the implants without any emphasis on the angulation of the drill, thus allowing too much flexibility in the final positioning of the implant.
Blustein et al7Â Â and Engelman et al8 described...
Various techniques have been proposed for the fabrication of surgical guide templates in implant dentistry. The objective of this paper is to review the associated literature and recent advancements in this field, based on design concept. An electronic and hand search of the literature revealed 3 categories, namely, nonlimiting, partially limiting, and completely limiting design. Most clinicians s...